What are the components that contribute to variability in echocardiographic measurements in aortic stenosis?

INTRODUCTION Echocardiography is the standard clinical approach for quantification of the severity of aortic stenosis (AS). A comprehensive examination of its overall reproducibility and the simultaneous estimation of its variance components by multiple operators, readers, probe applications, and beats have not been undertaken. METHOD AND RESULTS Twenty-seven subjects with AS were scanned over 7 months in the echo-department by a median of 3 different operators. From each patient and each operator multiple runs of beats from multiple probe positions were stored for later analysis by multiple readers. The coefficient of variation was 13.3%, 15.9%, 17.6%, and 20.2% for the aortic peak velocity (Vmax), and velocity time integral (VTI), and left ventricular outflow tract (LVOT) Vmax and VTI respectively. The largest individual contributors to the overall variability were the beat-to-beat variability (9.0%, 9.3%, 9.5%, 9.4% respectively) and that of inability of an individual operator to precisely apply the probe to the same position twice (8.3%, 9.4%, 12.9%, 10.7% respectively). The tracing (inter-reader) and reader (inter-reader), and operator (inter-operator) contribution were less important. CONCLUSIONS Reproducibility of measurements in AS is poorer than often reported in the literature. The source of this variability does not appear, as traditionally believed, to result from a lack of training or operator and reader specific factors. Rather the unavoidable beat-to-beat biological variability, and the inherent impossibility of applying the ultrasound probe in exactly the same position each time are the largest contributors. Consequently, guidelines suggesting greater standardisation of procedures and further training for sonographers are unlikely to result in an improvement in precision. Clinicians themselves should be wary of relying on even three-beat averages as their expected coefficient of variance is 10.3% for the peak velocity at the aortic valve.

A spectroscopic and photometric study of stellar populations in a sample of clusters in the Magellanic Clouds

This Ph.D. Thesis has been carried out in the framework of a long-term and large project devoted to describe the main photometric, chemical, evolutionary and integrated properties of a representative sample of Large and Small Magellanic Cloud (LMC and SMC respectively) clusters. The globular clusters system of these two Irregular galaxies provides a rich resource for investigating stellar and chemical evolution and to obtain a detailed view of the star formation history and chemical enrichment of the Clouds. The results discussed here are based on the analysis of high-resolution photometric and spectroscopic datasets obtained by using the last generation of imagers and spectrographs. The principal aims of this project are summarized as follows: • The study of the AGB and RGB sequences in a sample of MC clusters, through the analysis of a wide near-infrared photometric database, including 33 Magellanic globulars obtained in three observing runs with the near-infrared camera SOFI@NTT (ESO, La Silla). • The study of the chemical properties of a sample of MCs clusters, by using optical and near-infrared high-resolution spectra. 3 observing runs have been secured to our group to observe 9 LMC clusters (with ages between 100 Myr and 13 Gyr) with the optical high-resolution spectrograph FLAMES@VLT (ESO, Paranal) and 4 very young (<30 Myr) clusters (3 in the LMC and 1 in the SMC) with the near-infrared high-resolution spectrograph CRIRES@VLT. • The study of the photometric properties of the main evolutive sequences in optical Color- Magnitude Diagrams (CMD) obtained by using HST archive data, with the final aim of dating several clusters via the comparison between the observed CMDs and theoretical isochrones. The determination of the age of a stellar population requires an accurate measure of the Main Sequence (MS) Turn-Off (TO) luminosity and the knowledge of the distance modulus, reddening and overall metallicity. For this purpose, we limited the study of the age just to the clusters already observed with high-resolution spectroscopy, in order to date only clusters with accurate estimates of the overall metallicity.

Tuzla City (BiH): an example of geohazard induced by salt extraction

Salt deposits characterize the subsurface of Tuzla (BiH) and made it famous since the ancient times. Archeological discoveries demonstrate the presence of a Neolithic pile-dwelling settlement related to the existence of saltwater springs that contributed to make the most of the area a swampy ground. Since the Roman times, the town is reported as “the City of Salt deposits and Springs”; "tuz" is the Turkish word for salt, as the Ottomans renamed the settlement in the 15th century following their conquest of the medieval Bosnia (Donia and Fine, 1994). Natural brine springs were located everywhere and salt has been evaporated by means of hot charcoals since pre-Roman times. The ancient use of salt was just a small exploitation compared to the massive salt production carried out during the 20th century by means of classical mine methodologies and especially wild brine pumping. In the past salt extraction was practised tapping natural brine springs, while the modern technique consists in about 100 boreholes with pumps tapped to the natural underground brine runs, at an average depth of 400-500 m. The mining operation changed the hydrogeological conditions enabling the downward flow of fresh water causing additional salt dissolution. This process induced severe ground subsidence during the last 60 years reaching up to 10 meters of sinking in the most affected area. Stress and strain of the overlying rocks induced the formation of numerous fractures over a conspicuous area (3 Km2). Consequently serious damages occurred to buildings and infrastructures such as water supply system, sewage networks and power lines. Downtown urban life was compromised by the destruction of more than 2000 buildings that collapsed or needed to be demolished causing the resettlement of about 15000 inhabitants (Tatić, 1979). Recently salt extraction activities have been strongly reduced, but the underground water system is returning to his natural conditions, threatening the flooding of the most collapsed area. During the last 60 years local government developed a monitoring system of the phenomenon, collecting several data about geodetic measurements, amount of brine pumped, piezometry, lithostratigraphy, extension of the salt body and geotechnical parameters. A database was created within a scientific cooperation between the municipality of Tuzla and the city of Rotterdam (D.O.O. Mining Institute Tuzla, 2000). The scientific investigation presented in this dissertation has been financially supported by a cooperation project between the Municipality of Tuzla, The University of Bologna (CIRSA) and the Province of Ravenna. The University of Tuzla (RGGF) gave an important scientific support in particular about the geological and hydrogeological features. Subsidence damage resulting from evaporite dissolution generates substantial losses throughout the world, but the causes are only well understood in a few areas (Gutierrez et al., 2008). The subject of this study is the collapsing phenomenon occurring in Tuzla area with the aim to identify and quantify the several factors involved in the system and their correlations. Tuzla subsidence phenomenon can be defined as geohazard, which represents the consequence of an adverse combination of geological processes and ground conditions precipitated by human activity with the potential to cause harm (Rosenbaum and Culshaw, 2003). Where an hazard induces a risk to a vulnerable element, a risk management process is required. The single factors involved in the subsidence of Tuzla can be considered as hazards. The final objective of this dissertation represents a preliminary risk assessment procedure and guidelines, developed in order to quantify the buildings vulnerability in relation to the overall geohazard that affect the town. The historical available database, never fully processed, have been analyzed by means of geographic information systems and mathematical interpolators (PART I). Modern geomatic applications have been implemented to deeply investigate the most relevant hazards (PART II). In order to monitor and quantify the actual subsidence rates, geodetic GPS technologies have been implemented and 4 survey campaigns have been carried out once a year. Subsidence related fractures system has been identified by means of field surveys and mathematical interpretations of the sinking surface, called curvature analysis. The comparison of mapped and predicted fractures leaded to a better comprehension of the problem. Results confirmed the reliability of fractures identification using curvature analysis applied to sinking data instead of topographic or seismic data. Urban changes evolution has been reconstructed analyzing topographic maps and satellite imageries, identifying the most damaged areas. This part of the investigation was very important for the quantification of buildings vulnerability.

Experimental and numerical analyses about the efficiency of flow through devices for the sediment controll in urban runoff

As land is developed, the impervious surfaces that are created increase the amount of runoff during rainfall events, disrupting the natural hydrologic cycle, with an increment in volume of runoff and in pollutant loadings. Pollutants deposited or derived from an activity on the land surface will likely end up in stormwater runoff in some concentration, such as nutrients, sediment, heavy metals, hydrocarbons, gasoline additives, pathogens, deicers, herbicides and pesticides. Several of these pollutants are particulate-bound, so it appears clear that sediment removal can provide significant water-quality improvements and it appears to be important the knowledge of the ability of stromwater treatment devices to retain particulate matter. For this reason three different units which remove sediments have been tested through laboratory. In particular a roadside gully pot has been tested under steady hydraulic conditions, varying the characteristics of the influent solids (diameter, particle size distribution and specific gravity). The efficiency in terms of particles retained has been evaluated as a function of influent flow rate and particles characteristics; results have been compared to efficiency evaluated applying an overflow rate model. Furthermore the role of particles settling velocity in efficiency determination has been investigated. After the experimental runs on the gully pot, a standard full-scale model of an hydrodynamic separator (HS) has been tested under unsteady influent flow rate condition, and constant solid concentration at the input. The results presented in this study illustrate that particle separation efficiency of the unit is predominately influenced by operating flow rate, which strongly affects the particles and hydraulic residence time of the system. The efficiency data have been compared to results obtained from a modified overflow rate model; moreover the residence time distribution has been experimentally determined through tracer analyses for several steady flow rates. Finally three testing experiments have been performed for two different configurations of a full-scale model of a clarifier (linear and crenulated) under unsteady influent flow rate condition, and constant solid concentration at the input. The results illustrate that particle separation efficiency of the unit is predominately influenced by the configuration of the unit itself. Turbidity measures have been used to compare turbidity with the suspended sediments concentration, in order to find a correlation between these two values, which can allow to have a measure of the sediments concentration simply installing a turbidity probe.

Thermal and air quality modeling of an electric vehicle cabin with low-cost sensors and reinforcement learning

The design process of any electric vehicle system has to be oriented towards the best energy efficiency, together with the constraint of maintaining comfort in the vehicle cabin. Main aim of this study is to research the best thermal management solution in terms of HVAC efficiency without compromising occupant’s comfort and internal air quality. An Arduino controlled Low Cost System of Sensors was developed and compared against reference instrumentation (average R-squared of 0.92) and then used to characterise the vehicle cabin in real parking and driving conditions trials. Data on the energy use of the HVAC was retrieved from the car On-Board Diagnostic port. Energy savings using recirculation can reach 30 %, but pollutants concentration in the cabin builds up in this operating mode. Moreover, the temperature profile appeared strongly nonuniform with air temperature differences up to 10° C. Optimisation methods often require a high number of runs to find the optimal configuration of the system. Fast models proved to be beneficial for these task, while CFD-1D model are usually slower despite the higher level of detail provided. In this work, the collected dataset was used to train a fast ML model of both cabin and HVAC using linear regression. Average scaled RMSE over all trials is 0.4 %, while computation time is 0.0077 ms for each second of simulated time on a laptop computer. Finally, a reinforcement learning environment was built in OpenAI and Stable-Baselines3 using the built-in Proximal Policy Optimisation algorithm to update the policy and seek for the best compromise between comfort, air quality and energy reward terms. The learning curves show an oscillating behaviour overall, with only 2 experiments behaving as expected even if too slow. This result leaves large room for improvement, ranging from the reward function engineering to the expansion of the ML model.